Nulliparous is the clinical term for a female who’s never given birth, whether by choice or for any other cause. This is likely out of a conscious choice not to get pregnant, or they are always experiencing pregnancy-related complications whenever they become pregnant.
According to a survey conducted by the National Institutes of Health (NIH), the population of nulliparous females consists 40% of yearly births in the United States. This concept also defines women who have delivered a stillborn infant or a infant incapable of surviving outside the womb environment.
The etymology of the word is rooted in Latin. “Null” meaning “not” and the verb “parere,” meaning “to bring forth.” Nulliparous females are more vulnerable to some health issues than their non-nulliparous counterparts.
Such health issues include breast and reproductive cancers. Being nulliparous doesn’t mean that an individual has never conceived. Even a woman who has experienced a miscarriage or opted for abortion is nulliparous.
The purpose of this article is to explain this medical concept, related medical concepts and possible health effects that medical practitioners tend to affiliate with being nulliparous.
This article also covers secure contraceptive methods for nulliparous individuals.
Related terms to nulliparous
Primiparous is a term that qualifies females who have delivered one live infant or who are going through their first pregnancy.
Multiparous is a term that qualifies females who have delivered more than one baby. Multiparity also extends to females who have had multiple live births. It even further extends to females who have delivered multiple infants at a time, twins, or triplets, for example.
Health effects affiliated to nulliparity
Although being nulliparous doesn’t designate a person’s health status. However, nulliparous females may have a higher vulnerability to specific medical conditions.
Risk of uterine and ovarian cancers
According to the American Cancer Society (ACS), females who experience their first-ever childbirth after 35 years of age, and those experiencing nulliparity, have a heightened risk of ovarian cancer and uterine cancer.
In 2012, a study discovered that Catholic nuns have a noticeably higher risk of ovarian, uterine, and breast cancers.
The authors of the study connected the heightened risk of reproductive cancer with catholic nuns observing abstinence from sex and not using contraceptives. However, a study in 2013 stated that the nun study did not answer the age-related variances in cancer risks.
When the authors placed the nuns in comparison to the population under study, those nuns above the age of 80 years displayed the apex death rates from breast, uterine, and ovarian cancers. Ovarian and uterine cancer death rates decreased after the age of 80 in the population under study.
The authors of the 2013 study, made conclusions that being nulliparous may rather have some insuring impacts against ovarian and uterine cancer for females below the age of 60.
According to the Centers for Disease Control and Prevention (CDC), an estimated 12% of females in the age bracket of 15–44 years in the U.S. experience difficulties in conceiving. It is vague whether being nulliparous heightens the risk of infertility.
Nonetheless, being nulliparous may show underlying fertility issues. The fact that a female has never delivered an infant doesn’t automatically mean they are sterile. A nulliparous female may experience no difficulties whatsoever in conceiving or delivering a baby.
Infertility can occur in multiple forms. For some, infertility describes the inability to conceive. For others with infertility issues, they may conceive successfully but fail to carry the pregnancy to full term.
A nulliparous female with one or multiple risk factors for infertility may experience difficulties in conception or maintaining a full-term pregnancy.
The risk factors for infertility are as follows:
- Smoking history
- Heavy alcohol consumption
- Being overweight or underweight
- Previous or present experience of a sexually transmitted infection(s)
- Polycystic ovarian syndrome (PCOS)
- Major ovarian insufficiency
- Infertility rates are amplified among females with a history of two or multiple miscarriages, according to a study in 2017.
Females who give birth to children before the age of 20 have a lesser lifetime vulnerability to breast cancer than their nulliparous counterparts. However, young mothers have an increased risk for the initial 15 years post-pregnancy.
Mothers with as much as five full-term pregnancies have a likelihood of about 50% less than nulliparous females to develop breast cancer. Breastfeeding, which nulliparous females haven’t experienced, has also been found to reduce their vulnerability to breast cancer.
Also, among nulliparous females aged 35 and above, there’s a higher risk of delivering a stillborn baby, according to a study conducted on 1.8 million pregnancies, and reported in the journal Obstetrics & Gynecology.
Pregnancy and child-bearing risks
According to a study in 2019, females who have had one or multiple live births have a lesser vulnerability to pregnancy-related complications. These complications may include preeclampsia and preterm childbirth.
A 2019 study conducted on 137,791 females revealed that the risk for premature delivery and high blood pressure triggered by pregnancy started going higher at the ages of 20–24 in nulliparous females. Notwithstanding, the risk for such complications doesn’t heighten until the ages of 40 – 49 years for females who have had one or multiple childbirths.
Childbearing may take a more extended period for nulliparous females. A 2020 study conducted on 35,146 deliveries showed that the initial stage of childbirth lasted 1 hour, 40 minutes longer for nulliparous females than multiparous females.
The latent stage of child-bearing, which describes the period it takes the cervix to reach 10 centimetres in diameter, took 120–140 minutes longer for nulliparous females.
Causes of nulliparity
Nulliparity refers to the childbirth history of a female. It is not a health condition or a diagnosis. There are multiple, likely reasons for being nulliparous:
- A female might be nulliparous by choice due to using contraceptives or observing abstinence from sex
- Other females may have a history of the conception, but it didn’t lead to live childbirth due to miscarriage, stillbirths, or voluntary abortions.
Secure contraceptive measures/methods
Nulliparous women can securely make use of several methods of contraception. In a 2017 committee statement, the American College of Obstetrician and Gynecologists stated that intrauterine devices (IUDs) and contraceptive implants are the most secure and most potent contraceptive measures for nulliparous women and teenagers.
Despite its potency, IUD utilization is consistently low among nulliparous women. According to a study in 2015, rates of long-functioning reversible contraceptives usage among nulliparous women in the U.S. went up from 2.1% to 5.9% between 2009 and 2012.
The authors of another study in 2015 maintained that young and nulliparous women are not aware that intrauterine devices are readily obtainable. The authors also concluded that the low adoption rates of intrauterine devices are due to provider misconceptions.
According to the study, an estimated 43% of providers considered intrauterine devices as first-line contraceptive measures for adolescents.
Women are nulliparous if they haven’t gone through live childbirth. This may be because of pregnancy-related complications or their choice to opt for contraceptives or abstain from having sex.
Some studies have affiliated nulliparity with specific health risks such as higher cervical, uterine, and breast cancer rates.
Nonetheless, nulliparity does not translate to a female being less healthy or sterile. Several factors can influence an individual’s risk for any medical condition. Factors such as age, family medical/genetic history, and lifestyle choices.
These factors will likely have a stronger or more potent effect on an individual’s health status than their childbirth history. Individuals can lessen their vulnerabilities to reproductive cancers by being present at frequent screenings and addressing personal risk factors with their doctor.